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1.

Name (First and last)

50 characters left.

2.

Age

50 characters left.

3.

E-mail address (best to contact you at if there is a change in the class schedule)

50 characters left.

4.

Company/Corporate class location and specific building if applicable

50 characters left.

5.

Day of the week and time of class. Please indicate if you are ONLY a substitute in the class (if this option is allowed at your location).

350 characters left.

6.

Employee ID number

350 characters left.

7.

How do you relax on a regular basis?

350 characters left.

8.

Please briefly describe your current exercise program.

350 characters left.

9.

List any history of surgeries, illnesses, chronic conditions, accidents, special physical limitations. These include but are not limited to asthma, depression, anxiety, osteoporosis, arthritis, shoulder injuries or lack of rotation, hip replacement, carpal tunnel syndrome, pregnancy, sciatica, back injuries, sacroiliac injuries, low or high blood pressure, schizophrenia, etc.

350 characters left.

10.

What is your primary reason for taking this class (ie. flexibility, exercise, stress relief, team building, etc.)? What do you hope to get out of the class (ie. build on what you learned last session, learn something new, strengthen a certain area of the body, etc.)?

350 characters left.

11.

Please see the link for our waiver of liability*: http://inwardoffice.com/blog/wp-content/uploads/2012/10/Inward-Office-General-Liability-Release-Business.pdf

*NOTE: If your web browser prevents the .pdf from opening, please cut and paste the URL into the navigation bar manually.